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Post cath ECG: Now there are hyperacute T-waves again, and recurrent ST depression in V2 This ECG would normally diagnostic of OMI until proven otherwise No further troponins were measured, but it looks like there is recurrent OMI Next day: A CT CoronaryAngiogram was done (CTCA) CARDIAC MORPHOLOGY AND FUNCTION: 1. IMPRESSION: 1.
A CTCA provides much more anatomical detail and can identify advanced plaque often missed by CT Coronary Artery Calcium Score scans alone. CT Coronary Artery Calcium Score Scan CT Coronary Artery Calcium Score CT CoronaryAngiogram As you can see from the above images, the CTCA provides far more anatomical detail.
Cardiology admitted him for observation with plans for next-day coronaryangiogram. The peak Troponin I confirmed myocardialinfarction. (A Unfortunately, due to the patient’s abrupt exodus from the PCI center – without benefit of coronaryangiogram, or echo, for example – the disposition will forever remain unknown. [1]
Ct coronaryangiogram showed normal coronary arteries. Smith note: I think CT coronaryangiogram is reasonable with the elevated troponins and symptoms. The important point for our purposes is that they do no represent myocardialinfarction. International Journal of Cardiology 2019.
Incidence of an acute coronary occlusion. Am J Med 2019, 132(5):622-630. New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardialinfarction in the emergency department. Incidence of an Acute Coronary Occlusion. American Journal of Medicine 132(5):622-630; May 2019.
Cardiology felt her chest pain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. Type II MI), however decided to pursue coronaryangiogram out of an abundance of caution. A mid-LAD culprit lesion was identified and stented. References Naidu, S. Tower-Rader, A.
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